Moy Foong Ming, Hoe Victor Chee Wai, Hairi Noran Naqiah, Chu Anne Hin Yee, Bulgiba Awang, Koh David
Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Centre for Occupational and Environmental Health-UM, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2015 Nov 5;10(11):e0141963. doi: 10.1371/journal.pone.0141963. eCollection 2015.
To establish the prevalence of voice disorder using the Malay-Voice Handicap Index 10 (Malay-VHI-10) and to study the determinants, quality of life, depression, anxiety and stress associated with voice disorder among secondary school teachers in Peninsular Malaysia.
This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance.
In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p < 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score > 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06).
The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers.
使用马来语语音障碍指数10（Malay-VHI-10）确定语音障碍的患病率，并研究马来西亚半岛中学教师中与语音障碍相关的决定因素、生活质量、抑郁、焦虑和压力。
本研究分为两个阶段。第一阶段测试Malay-VHI-10的可靠性，而第二阶段是采用两阶段抽样的横断面研究。在第二阶段，使用自填式问卷收集社会人口统计学和教学特征、抑郁、焦虑和压力量表（马来语版DASS-21）；以及与健康相关的生活质量（马来语版SF12-v2）。使用具有稳健方差的多元泊松回归进行复杂样本分析。
在第一阶段，VHI-10总分的Spearman相关系数和Cronbach阿尔法系数分别为0.72（p<0.001）和0.77；显示出良好的相关性和内部一致性。组内相关系数（ICC）范围为0.65至0.78，显示出中等至良好的可靠性，并表明各子量表可靠且稳定。共有6039名教师参与了第二阶段。他们主要是马来人、女性、已婚、完成了高等教育且年龄在30至50岁之间。共有10.4%（95%可信区间7.1，14.9）的教师存在语音障碍（VHI-10得分>11）。与马来人相比，华裔教师报告语音障碍的比例更高，而印度裔教师报告此问题的可能性较小。单身或离异/丧偶教师中语音障碍的患病率更高。存在语音障碍的教师更有可能报告更高的缺勤率（患病率比：1.70，95%可信区间1.33，2.19）、较低的生活质量，SF12-v2身体（0.98，95%可信区间0.96，0.99）和心理（0.97，95%可信区间0.96，0.98）分量表得分较低；以及较高的焦虑水平（1.04，95%可信区间1.02，1.06）。
Malay-VHI-10有效且可靠。语音障碍与教师缺勤率增加有关，与健康相关生活质量下降以及焦虑增加有轻微关联。
